OBJECTIVES:

Patients with RRMM receive multiple treatments, including proteasome inhibitors (PIs), immunomodulatory drugs (IMiDs), and anti-CD38 monoclonal antibodies (mAb). We analyzed real-world costs and HCRU in patients with triple-class exposed RRMM.

METHODS:

We performed a retrospective cohort analysis using data from the Optum Clinformatics Data Mart database (01/01/2010-12/31/2020). Patients aged ≥18 years had a diagnosis of MM and no other cancer 1 year before index diagnosis. Patients had ≥3 prior lines of therapy (LOT; a PI, an IMiD, and an anti-CD38 mAb) and ≥1 LOT post-triple-class exposure (TCE). Comorbidities were scored per the Charlson Comorbidity Index (CCI). Elixhauser comorbidities (diagnosis codes) were captured. Per-patient per-month (PPPM) costs from the first LOT post-TCE to loss to follow-up (LTFU) were calculated. Number of outpatient visits, hospitalizations, emergency room (ER) visits, and lab visits PPPM were assessed. Descriptive statistics are reported as mean (median) unless otherwise stated.

RESULTS:

The 234 patients included were aged 72 (73) years. 80.0% had a CCI score ≥2. The most common Elixhauser comorbidity was hypertension (79.1%); 47.9%, 30.3% and 21.8% received 3, 4 and ≥5 prior LOT, respectively. 20.9% were triple-class refractory, and 35.0% had prior stem cell transplant. The most common treatments post-TCE were daratumumab- (59.8%), pomalidomide- (37.2%), and carfilzomib- (22.2%) containing regimens. Time from the start of first LOT post-TCE to LTFU was 8.4 (5.4) months and PPPM cost was $29,748 ($28,258; drug costs: $15,345 [$14,755]). The number of outpatient visits, hospitalizations, ER visits and lab visits PPPM were 5.4 (4.7), 0.3 (0.2), 0.3 (0.2), and 2.5 (2.2), respectively. The length of hospital stay was 1.6 (0.7) days PPPM; 2.3 (1.3) days PPPM in patients with ≥1 hospitalization.

CONCLUSIONS: Patients with TCE RRMM incur high costs that could potentially be decreased by effective treatments with novel mechanisms of action.